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The NHS in England will be set targets on getting people back to work, as ministers plan to link patient data to employment status and benefits claims to assess how much the health service boosts the economy.
Wes Streeting, the health secretary, is promising to make the NHS “accountable” for whether patients are in work by introducing goals across England for how many people the health service should get to return to employment.
Ministers hope to use the NHS to reduce Britain’s rising sickness benefit bill and deal with a post-pandemic high of 2.8mn people out of work through long-term illness.
They want the health service to focus more on the employment status of those of working age, despite a traditional reluctance among clinical staff to take economic considerations into account in prioritising treatment.
Local health boards will this week be told to begin the process of developing nationwide employment targets after ministers were encouraged by early-stage pilots, according to people briefed on the plans.
Initiatives in Yorkshire, Cumbria and the North East have been offering treatments ranging from cardiac rehabilitation to physiotherapy and occupational health with the explicit goal of getting patients back to work.
Employment coaches are also being used to offer patients practical advice on getting jobs after the NHS 10-year plan last year said the health service needed to recognise that work was good for people’s health.
Detailed evaluation of the pilots is due to be set out in the coming months, at which point officials hope to have agreed employment targets for each of England’s integrated care boards (ICBs).
These are likely to include reducing the number of economically inactive people in the local area by about 1 per cent. They will also feature measures to assess how many more patients stay in work or get jobs than might have been expected without targeted treatment.
Initially ICBs will not be penalised if they miss the targets, although officials plan that in future years NHS payments will be linked to performance against these measures.
Next year officials plan to go further in pilot areas by linking patients’ NHS numbers to Office for National Statistics data on pay and employment, along with government records of benefit claims, to assess treatments’ effects on joblessness.
There are currently 9mn economically inactive people of working age, of whom 2.8mn are long-term sick — around 700,000 above pre-Covid levels. Spending on incapacity and sickness benefits has also been rising, with total sickness benefits cost projected to exceed £100bn by the end of the decade.
After the government was forced to retreat on an attempt last year to cut disability benefits, ministers have been focusing on other ways to reduce sickness spending and keep people in work.
Streeting said: “For the first time, we are making the NHS accountable for patients’ employment outcomes, to drive better rehab and long-term health.”
He added: “The NHS is great at patching us up, but too often it then sends us home without the support we need to get back on our feet. That’s bad for patients, bad for our economy and bad for the NHS, because we end up walking back through its doors sooner than we should.”
The Department of Health and Social Care is putting an extra £25mn into the £45mn already being spent on pilots to prepare for a national rollout.
However, the initiative may also add to fears about the rise of a “national health state” as the NHS takes on ever more responsibilities from other public services which have faced cuts. Streeting has also promised to free up local health bosses by cutting back targets.
Jeremy Hunt, the Conservative former health secretary, said employment targets risked becoming “yet another example of a worthy goal which will end up being another target that makes the NHS more micromanaged and less effective”.